Τίτλος:
Vitamin D-related immunomodulation in patients with liver cirrhosis
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Objective(s) Increasing evidence indicates that Vitamin D status is linked to severity of liver cirrhosis and patients' survival. However, the potential role of Vitamin D-related immunomodulation in hepatic decompensation and patients' mortality in relation to Vitamin D deficiency remains unknown. The aim of the current study is to evaluate the association between Vitamin D status and Vitamin D binding protein (VDBP) levels with serum cytokine and lipopolysaccharide binding protein (LBP) and to examine their role on disease severity and cirrhotics' mortality. Methods One hundred consecutive Caucasian patients with liver cirrhosis were enrolled in the study. 25(OH)D, VDBP, and LBP concentrations were assessed by ELISA. Cytokine tumor necrosis factor-a (TNF-a), interleukin 6 (IL-6), IL-1ß, IL-8, IL-10, and IL-12 levels were determined by Cytometric Bead Array. Results 25(OH)D levels were inversely correlated with CP score, MELD, IL-6, and CP stage and VDBP levels with CP score, MELD, IL-6, IL-8, LBP, and CP stage. Cirrhotics with 25(OH)D deficiency and severe deficiency had significantly higher CP score, increased IL-6 levels and lower VDBP levels. In the multivariate analysis, the independent prognostic factors associated with patients' survival were CP stage B [hazard ratio = 6.75; 95% confidence interval (CI) 1.32, 34.43; P = 0.022], CP stage C (hazard ratio = 7.39; 95% CI 1.41, 38.81; P = 0.018), the presence of hepatocellular carcinoma (hazard ratio = 4.50; 95% CI 1.54, 13.13; P = 0.006) and 25(OH)D levels (hazard ratio = 0.87; 95% CI 0.80, 0.95; P = 0.002). Conclusion The results show that Vitamin D status and VDBP levels are associated with liver cirrhosis severity and patients' mortality, possibly through a proinflammatory immune response. © 2020 Lippincott Williams and Wilkins. All rights reserved.
Συγγραφείς:
Triantos, C.
Kalafateli, M.
Aggeletopoulou, I.
Diamantopoulou, G.
Spantidea, P.I.
Michalaki, M.
Vourli, G.
Konstantakis, C.
Assimakopoulos, S.F.
Manolakopoulos, S.
Gogos, C.
Kyriazopoulou, V.
Mouzaki, A.
Thomopoulos, K.
Περιοδικό:
European Journal of Gastroenterology and Hepatology
Εκδότης:
Lippincott Williams and Wilkins
Λέξεις-κλειδιά:
alanine aminotransferase; albumin; alkaline phosphatase; aspartate aminotransferase; bilirubin; bilirubin glucuronide; calcium ion; cholesterol; creatinine; gamma glutamyltransferase; glucose; hemoglobin; high density lipoprotein; interleukin 10; interleukin 12; interleukin 1beta; interleukin 6; interleukin 8; lipopolysaccharide binding protein; low density lipoprotein; magnesium; phosphorus; potassium; protein; sodium ion; triacylglycerol; tumor necrosis factor; urea; vitamin D; vitamin D binding protein; vitamin D, adult; Article; ascites; bacterial translocation; brain disease; Caucasian; controlled study; diastolic blood pressure; disease severity; enzyme linked immunosorbent assay; female; gastrointestinal hemorrhage; hematocrit; hepatorenal syndrome; human; human tissue; immunomodulation; international normalized ratio; liver cell carcinoma; liver cirrhosis; major clinical study; male; middle aged; mortality; platelet count; priority journal; prognosis; protein blood level; prothrombin time; systolic blood pressure; vitamin D deficiency; immunity; liver cirrhosis; liver tumor; vitamin D deficiency, Humans; Immunity; Immunomodulation; Liver Cirrhosis; Liver Neoplasms; Vitamin D; Vitamin D Deficiency
DOI:
10.1097/MEG.0000000000001597
